The significance of breast carcinomas (BCs) with a single HR-positive phenotype (ER+/PgR–or ER–/PgR+) is still poorly understood.
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13, 14 All of these features point toward the heterogeneous nature of an HR-negative subgroup of invasive breast cancers and may indicate the presence of more aggressive subgroups that could benefit from a more aggressive therapeutic approach. 11, 12 Medullary carcinomas are also typically HR negative and have better prognosis. 8- 10 However, some types of invasive carcinoma that are typically HR negative such as adenoid cystic carcinoma and secretory carcinoma have an excellent prognosis with minimal regional recurrence. HR-negative tumors are more likely to be of higher grade and associated with a higher recurrence rate, decreased overall survival, and unresponsiveness to antiestrogens. 1 Some authors reported that lack of PgR expression in ER+ tumors may be a surrogate marker of aberrant growth factor signaling that could contribute to tamoxifen resistance, 2 and others have demonstrated that PgR is a stronger predictor of response to hormonal treatment than ER. Its presence in breast tumors is used to predict functional estrogen receptor (ER) and, therefore, the likelihood of response to endocrine therapies and disease prognosis. Progesterone receptor (PgR) is a ligand-activated nuclear transcription factor that mediates progesterone action. The nuclear receptor for estrogen functions as a transcription factor controlling estrogen-regulated genes. However, the contribution of each receptor, or their combinations, remains controversial.
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Therefore, it is critical to evaluate HR status when considering endocrine therapy. Steroid hormone receptors (HRs) have been shown to be prognostic and, more importantly, a predictive marker for endocrine therapy in the clinical management of breast cancer.